Psychiatric and Mental Health Nursing Across the Lifespan Exam Preparation Guide - 803 Verified Ques

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Psychiatric and Mental Health Nursing Across the Lifespan Exam Preparation Guide

Course Introduction

This course explores the principles and practices of psychiatric and mental health nursing for individuals throughout all stages of life, from childhood to older adulthood.

Emphasizing evidence-based interventions, students learn to assess, plan, implement, and evaluate care for patients experiencing a variety of mental health disorders in diverse settings. The course covers topics such as therapeutic communication, crisis intervention, psychopharmacology, cultural considerations, legal and ethical aspects, and collaboration within interdisciplinary teams. Students develop critical thinking and clinical decision-making skills necessary for promoting mental well-being and recovery, while addressing the unique needs of patients and families across the lifespan.

Recommended Textbook

Essentials of Psychiatric Mental Health Nursing 3rd Edition by Varcarolis

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28 Chapters

803 Verified Questions

803 Flashcards

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Chapter 1: Practicing the Science and Art of Psychiatric Nursing

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15 Verified Questions

15 Flashcards

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Sample Questions

Q1) A nurse says, "When I was in school, I learned to call upset patients by name to get their attention; however, I read a descriptive research study that says that this approach does not work. I plan to stop calling patients by name." Which statement is the best appraisal of this nurse's comment?

A) One descriptive research study rarely provides enough evidence to change practice.

B) Staff nurses apply new research findings only with the help from clinical nurse specialists.

C) New research findings should be incorporated into clinical algorithms before using them in practice.

D) The nurse misinterpreted the results of the study. Classic tenets of practice do not change.

Answer: A

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Chapter 2: Mental Health and Mental Illness

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17 Flashcards

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Sample Questions

Q1) A nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patient's insurance form. Which resource should the nurse consult to discern the criteria used to establish this diagnosis?

A) A psychiatric nursing textbook

B) NANDA International (NANDA-I)

C) A behavioral health reference manual

D) Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Answer: D

Q2) A participant at a community education conference asks, "What is the most prevalent type of mental disorder in the United States?" Select the nurse's best response. A) "Why do you ask?"

B) "Schizophrenia"

C) "Affective disorders"

D) "Anxiety disorders"

Answer: D

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Chapter 3: Theories and Therapies

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Sample Questions

Q1) A nurse psychotherapist works with an anxious, dependent patient. The therapeutic strategy most consistent with the framework of psychoanalytic psychotherapy is:

A) emphasizing medication compliance.

B) identifying the patient's strengths and assets.

C) offering psychoeducational materials and groups.

D) focusing on feelings developed by the patient toward the nurse.

Answer: D

Q2) A nurse supports parental praise of a child who is behaving in a helpful way. When the individual behaves with politeness and helpfulness in adulthood, which feeling will most likely result?

A) Guilt

B) Anxiety

C) Loneliness

D) Self-esteem

Answer: D

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Chapter 4: Biological Basis for Understanding

Psychopharmacology

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Sample Questions

Q1) A drug causes muscarinic-receptor blockade. A nurse will assess the patient for:

A) dry mouth.

B) gynecomastia.

C) pseudoparkinsonism.

D) orthostatic hypotension.

Q2) A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to:

A) mood improvement.

B) logical thought processes.

C) reduced levels of motor activity.

D) decreased extrapyramidal symptoms.

Q3) A patient has symptoms of acute anxiety related to the death of a parent in an automobile accident 2 hours earlier. The nurse should anticipate administering a medication from which group?

A) Tricyclic antidepressants

B) Atypical antipsychotics

C) Anticonvulsants

D) Benzodiazepines

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Chapter 5: Settings for Psychiatric Care

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Sample Questions

Q1) Which assessment finding for a patient living in the community requires priority intervention by the nurse? The patient:

A) receives Social Security disability income plus a small check from a trust fund.

B) lives in an apartment with two patients who attend day hospital programs.

C) has a sibling who is interested and active in care planning.

D) purchases and uses marijuana on a frequent basis.

Q2) A patient hurriedly tells the community mental health nurse, "Everything's a disaster! I can't concentrate. My disability check didn't come. My roommate moved out, and I can't afford the rent. My therapist is moving away. I feel like I'm coming apart." Nursing interventions should be focused on which problem?

A) Assisting the patient to clarify personal values

B) Coping with feelings of abandonment

C) Coping with anxiety that may lead to psychological disequilibrium

D) Clarifying misperceptions of the environment,

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Chapter 6: Legal and Ethical Basis for Practice

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Sample Questions

Q1) Which documentation of a patient's behavior best demonstrates a nurse's observations?

A) Isolates self from others. Frequently fell asleep during group. Vital signs stable.

B) Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking.

C) Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others

D) Wears four layers of clothing. States, "I need protection from dangerous bacteria trying to penetrate my skin."

Q2) A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse should:

A) implement the order.

B) consult a drug reference.

C) give the usual geriatric dosage.

D) hold the medication and consult the health care provider.

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Chapter 7: Nursing Process and QSEN: The Foundation for

and Effective Care

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Sample Questions

Q1) At one point in an assessment interview a nurse asks, "How does your faith help you in stressful situations?" This question would be asked during the assessment of:

A) childhood growth and development.

B) substance use and abuse.

C) educational background.

D) coping strategies.

Q2) An adolescent asks a nurse conducting an assessment interview, "Why should I tell you anything? You'll just tell my parents whatever you find out." Select the nurse's best reply.

A) "That is not true. What you tell us is private and held in strict confidence. Your parents have no right to know."

B) "Yes, your parents may find out what you say, but it is important that they know about your problems."

C) "What you say about feelings is private, but some things, like suicidal thinking, must be reported to the treatment team."

D) "It sounds as though you are not really ready to work on your problems and make changes."

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Chapter 8: Communication Skills: Medium for All Nursing Practice

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Sample Questions

Q1) A Puerto Rican-American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient's behavior? The patient:

A) likely has a histrionic personality disorder.

B) believes dramatic body language is sexually appealing.

C) wishes to impress staff with the degree of emotional pain.

D) belongs to a culture in which dramatic body language is the norm.

Q2) The relationship between a nurse and patient as it relates to status and power is best described by which term?

A) Symmetric

B) Complementary

C) Incongruent

D) Paralinguistic

Q3) A patient with severe depression states, "God is punishing me for my past sins." What is the nurse's best response?

A) "Why do you think that?"

B) "You sound very upset about this."

C) "You believe God is punishing you for your sins?"

D) "If you feel this way, you should talk to a member of your clergy."

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Chapter 9: Therapeutic Relationships and the Clinical

Interview

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Sample Questions

Q1) Which behavior shows that a nurse values autonomy? The nurse:

A) sets limits on a patient's romantic overtures toward the nurse.

B) suggests one-on-one supervision for a patient who is suicidal.

C) informs a patient that the spouse will not be in during visiting hours.

D) discusses available alternatives and helps the patient weigh the consequences.

Q2) A patient says, "People should be allowed to commit suicide without interference from others." A nurse replies, "You're wrong. Nothing is bad enough to justify death." What is the best analysis of this interchange?

A) The patient is correct.

B) The nurse is correct.

C) Neither person is totally correct.

D) Differing values are reflected in the two statements.

Q3) During the first interview, a nurse notices that the patient does not make eye contact. The nurse can correctly analyze that:

A) the patient is not truthful.

B) the patient is feeling sad.

C) the patient has a poor self-concept.

D) more information is needed to draw a conclusion.

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Chapter 10: Trauma and Stress-Related Disorders

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Sample Questions

Q1) A veteran of the war in Afghanistan was diagnosed with posttraumatic stress disorder (PTSD). The veteran says, "If there's a loud noise at night, I get under my bed because I think we're getting bombed." What type of experience has the veteran described?

A) Illusion

B) Flashback

C) Nightmare

D) Auditory hallucination

Q2) A patient diagnosed with liver failure has been on the transplant waiting list 8 months. The patient says, "Why is it taking so long to have the surgery? Maybe I'm meant to die for all the bad things I've done." The nurse should document the patient's comment in which section of the assessment?

A) Physical

B) Spiritual

C) Financial

D) Psychological

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Chapter 11: Anxiety, Anxiety Disorders, and

Obsessive-Compulsive and Related Disorders

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Sample Questions

Q1) A child is placed in a foster home after being removed from parental contact because of abuse. The child is apprehensive and overreacts to environmental stimuli. The foster parents ask the nurse how to help the child. What should the nurse recommend? (Select all that apply.)

A) Use a calm manner and low voice.

B) Maintain simplicity in the environment.

C) Avoid repetition in what is said to the child.

D) Minimize opportunities for exercise and play.

E) Explain and reinforce reality to avoid distortions.

Q2) If a cruel and abusive person rationalizes this behavior, which comment is most characteristic of this person?

A) "I don't know why it happens."

B) "I have always had poor impulse control."

C) "That person should not have provoked me."

D) "Inside I am a coward who is afraid of being hurt."

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Chapter 12: Somatic Symptom Disorders and Dissociative Disorders

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Sample Questions

Q1) A patient reports fears of having cervical cancer and says to the nurse, "I've had Pap smears by six different doctors. The results are normal, but I'm sure that's because of errors in the laboratory." Which disorder would the nurse suspect?

A) Functional neurologic (conversion) disorder

B) Illness anxiety disorder (hypochondriasis)

C) Derealization disorder

D) Dissociative amnesia with fugue

Q2) A nurse assesses a patient suspected to have somatic system disorder. Which findings support the diagnosis? (Select all that apply.)

A) Female

B) Reports frequent syncope

C) Complains of heavy menstrual bleeding

D) First diagnosed with psoriasis at 12 years of age

E) Reports of back pain, painful urination, frequent diarrhea, and hemorrhoids

Q3) The causes of somatic system disorders may be related to:

A) faulty perceptions of body sensations.

B) traumatic childhood events.

C) culture-bound phenomena.

D) mood instability.

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Chapter 13: Personality Disorders

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Sample Questions

Q1) A patient diagnosed with borderline personality disorder self-inflicted wrist lacerations after gaining new privileges on the unit. The cause of the self-mutilation is probably related to:

A) inherited disorder that manifests itself as an incapacity to tolerate stress.

B) use of projective identification and splitting to bring anxiety to manageable levels.

C) constitutional inability to regulate affect, predisposing to psychic disorganization.

D) fear of abandonment associated with progress toward autonomy and independence.

Q2) Which intervention is appropriate for a patient diagnosed with an antisocial personality disorder who frequently manipulates others?

A) Refer the patient's requests and questions to the case manager.

B) Explore the patient's feelings of fear and inferiority.

C) Provide negative reinforcement for acting-out behavior.

D) Ignore, rather than confront, inappropriate behavior.

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Chapter 14: Eating Disorders

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Sample Questions

Q1) A psychiatric clinical nurse specialist uses cognitive therapy techniques with a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy?

A) "What are your feelings about not eating the food that you prepare?"

B) "You seem to feel much better about yourself when you eat something."

C) "It must be difficult to talk about private matters to someone you just met."

D) "Being thin does not seem to solve your problems. You are thin now but still unhappy."

Q2) Which nursing intervention has the highest priority for a patient diagnosed with bulimia nervosa?

A) Assist the patient to identify triggers to binge eating.

B) Provide corrective consequences for weight loss.

C) Explore patient needs for health teaching.

D) Assess for signs of impulsive eating.

Q3) Which statement is a nurse most likely to hear from a patient diagnosed with anorexia nervosa?

A) "I would be happy if I could lose 20 more pounds."

B) "My parents don't pay much attention to me."

C) "I'm thin for my height."

D) "I have nice eyes."

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Chapter 15: Mood Disorders: Depression

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Sample Questions

Q1) During a psychiatric assessment, the nurse observes a patient's facial expressions that are without emotion. The patient says, "Life feels so hopeless to me. I've been feeling sad for several months." How should the nurse document the patient's affect and mood?

A) Affect depressed; mood flat

B) Affect flat; mood depressed

C) Affect labile; mood euphoric

D) Affect and mood are incongruent

Q2) A patient being treated with paroxetine (Paxil) 50 mg/day orally for major depressive disorder reports to the clinic nurse, "I took a few extra tablets earlier in the day and now I feel bad." Which aspects of the nursing assessment are most critical? (Select all that apply.)

A) Vital signs

B) Urinary frequency

C) Increased suicidal ideation

D) Presence of abdominal pain and diarrhea

E) Hyperactivity or feelings of restlessness

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Chapter 16: Bipolar Spectrum Disorders

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Sample Questions

Q1) A patient diagnosed with bipolar disorder has been hospitalized for 7 days and has taken lithium 600 mg three times daily. Staff members observe increased agitation, pressured speech, poor personal hygiene, hyperactivity, and bizarre clothing. What is the nurse's best intervention?

A) Educate the patient about the proper ways to perform personal hygiene and coordinate clothing.

B) Continue to monitor and document the patient's speech patterns and motor activity.

C) Ask the health care provider to prescribe an increased dose and frequency of lithium.

D) Consider the need to check the lithium level. The patient may not be swallowing medications.

Q2) A patient experiencing mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and intrudes. Which nursing intervention will best assist the patient with energy conservation?

A) Monitor physiologic functioning

B) Provide a subdued environment

C) Supervise personal hygiene

D) Observe for mood changes

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Chapter 17: Schizophrenia Spectrum Disorders and Other

Psychotic Disorders

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Sample Questions

Q1) A patient diagnosed with schizophrenia has auditory hallucinations. The patient anxiously tells the nurse, "The voice is telling me to do things." Select the nurse's priority assessment question.

A) "How long has the voice been directing your behavior?"

B) "Do the messages from the voice frighten you?"

C) "Do you recognize the voice speaking to you?"

D) "What is the voice telling you to do?"

Q2) A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning. The patient is also overweight and has hypertension. Which drug should the nurse advocate?

A) Clozapine (Clozaril)

B) Ziprasidone (Geodon)

C) Olanzapine (Zyprexa)

D) Aripiprazole (Abilify)

Q3) Patients diagnosed with schizophrenia who are suspicious and withdrawn:

A) universally fear sexual involvement with therapists.

B) are socially disabled by the positive symptoms of schizophrenia.

C) exhibit a high degree of hostility as evidenced by rejecting behavior.

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D) avoid relationships because they become anxious with emotional closeness.

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Chapter 18: Neurocognitive Disorders

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Sample Questions

Q1) Consider these problems: apolipoprotein E (apoE) malfunction, neuritic plaques, neurofibrillary tangles, granulovascular degeneration, and brain atrophy. Which condition corresponds to this group?

A) Alzheimer disease

B) Wernicke encephalopathy

C) Central anticholinergic syndrome

D) Acquired immunodeficiency syndrome (AIDS)-related dementia

Q2) Two patients in a residential care facility are diagnosed with dementia. One shouts to the other, "Move along, you're blocking the road." The other patient turns, shakes a fist, and shouts, "I know what you're up to; you're trying to steal my car." What is the nurse's best action?

A) Administer one dose of an antipsychotic medication to both patients.

B) Reinforce reality. Say to the patients, "Walk along in the hall. This is not a traffic intersection."

C) Separate and distract the patients. Take one to the day room and the other to an activities area.

D) Step between the two patients and say, "Please quiet down. We do not allow violence here."

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Chapter 19: Substance-Related and Addictive Disorders

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Sample Questions

Q1) Which treatment approach is most appropriate for a patient with antisocial tendencies who has been treated several times for substance addiction but has relapsed?

A) One-week detoxification program

B) Long-term outpatient therapy

C) Twelve-step self-help program

D) Residential program

Q2) Which statement most accurately describes substance addiction?

A) A chronic, relapsing brain disease associated with craving and a lack of control over use of a substance.

B) A disorder associated with tolerance to a substance as well as withdrawal symptoms if use is abruptly discontinued.

C) Behaviors associated with habitual use of a substance for the single purpose of altering one's mood, emotion, or state of consciousness.

D) A behavioral disorder associated with selected personality features.

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Chapter 20: Crisis and Mass Disaster

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Sample Questions

Q1) Which premise is most useful to a nurse planning crisis intervention for any patient? The patient:

A) is experiencing a state of disequilibrium.

B) is experiencing a type of mental illness.

C) poses a threat of violence to others.

D) has a high potential for self-injury.

Q2) An adult has cared for a debilitated parent for 10 years. The parent's condition recently declined, and the health care provider recommended placement in a skilled care facility. The adult says, "I've always been able to care for my parents. Nursing home placement goes against everything I believe." Successful resolution of this person's crisis will most closely relate to:

A) resolving the feelings associated with the threat to the person's self-concept.

B) maintaining the ability to identify situational supports in the community.

C) relying on the assistance from role models within the person's culture.

D) mobilizing automatic relief behaviors by the person.

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Chapter 21: Child, Partner, and Elder Violence

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Sample Questions

Q1) A nurse visits the home of an 11-year-old child and finds the child caring for three younger siblings. Both parents are at work. The child says, "I want to go to school but we can't afford a babysitter. It doesn't matter; I'm too dumb to learn." What preliminary assessment is evident?

A) Insufficient data are present to make an assessment.

B) Child and siblings are experiencing neglect.

C) Children are at high risk for sexual abuse.

D) Children are experiencing physical abuse.

Q2) Which rationale best explains why a nurse should be aware of personal feelings while working with a family experiencing family violence?

A) Self-awareness protects one's own mental health.

B) Strong negative feelings interfere with assessment and judgment.

C) Strong positive feelings lead to underinvolvement with the victim.

D) Positive feelings promote the development of sympathy for patients.

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Chapter 22: Sexual Violence

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Sample Questions

Q1) A nurse interviews a person abducted and raped at gunpoint by an unknown assailant. The person says, "I can't talk about it. Nothing happened. I have to forget!" What is the person's present coping strategy?

A) Somatic reaction

B) Repression

C) Projection

D) Denial

Q2) An unconscious person is brought to the emergency department by a friend. The friend found the person in a bedroom at a college fraternity party. Semen is observed on the person's underclothes. The priority actions of staff members should focus on:

A) maintaining gas exchange.

B) preserving rape evidence.

C) obtaining a description of the rape.

D) determining what drug was ingested.

Q3) What is the primary motivator for most rapists?

A) Anxiety

B) Need for humiliation

C) Overwhelming sexual desires

D) Desire to humiliate or control others

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Chapter 23: Suicidal Thoughts and Behavior

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Sample Questions

Q1) Which intervention should a nurse recommend for the distressed family and friends of someone who has committed suicide?

A) Participating in reminiscence therapy

B) Attending a self-help group for survivors

C) Contracting for two sessions of group therapy

D) Completing a psychological postmortem assessment

Q2) Which understanding about individuals who attempt suicide will help a nurse plan the care for a suicidal patient? Every suicidal person should be considered:

A) mentally ill.

B) intent on dying.

C) cognitively impaired.

D) experiencing hopelessness.

Q3) A nurse and patient construct a no-suicide contract. Select the preferable wording for the contract.

A) "I will not try to harm myself during the next 24 hours."

B) "I will not make a suicide attempt while I am hospitalized."

C) "For the next 24 hours, I will not kill or harm myself in any way."

D) "I will not kill myself until I call my primary nurse or a member of the staff."

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25

Chapter 24: Anger, Aggression, and Violence

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Sample Questions

Q1) Which medication should a nurse administer to provide immediate intervention for a psychotic patient whose aggressive behavior continues to escalate despite verbal intervention?

A) Lithium (Eskalith)

B) Trazodone (Desyrel)

C) Olanzapine (Zyprexa)

D) Valproic acid (Depakene)

Q2) A patient with a history of command hallucinations approaches the nurse, yelling obscenities. The patient mumbles and then walks away. The nurse follows. Which nursing actions are most likely to be effective in de-escalating this scenario? (Select all that apply.)

A) State the expectation that the patient will stay in control.

B) State that the patient cannot be understood when mumbling.

C) Tell the patient, "You are behaving inappropriately."

D) Offer to provide the patient with medication to help.

E) Speak in a firm but calm, caring voice.

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Chapter 25: Care for the Dying and Those Who Grieve

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Sample Questions

Q1) A nurse cared for a terminally ill patient for over a month and always looked forward to spending time with the patient. When the patient died, the nurse experienced sadness and felt mildly depressed. Eventually, the nurse explains these feelings to a mentor. The mentor should counsel the nurse:

A) about stress-reduction strategies.

B) to seek therapy for dysfunctional grief.

C) about the experience of disenfranchised grief.

D) to consider taking a leave of absence to pursue healing.

Q2) Which actions by a nurse contribute to protecting the rights of patients who are terminally ill? (Select all that apply.)

A) Maintain hope for a positive prognosis.

B) Hug the patient when sadness is expressed.

C) Offer choices that promote personal control.

D) Provide interventions that convey respect.

E) Support the patient's quest for spiritual growth.

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Chapter 26: Children and Adolescents

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Sample Questions

Q1) An adolescent diagnosed with generalized anxiety disorder says, "My parents focus all their attention on my brother instead of me. He's perfect in their eyes." Which type of therapy might promote the greatest change in this adolescent's behavior?

A) Bibliotherapy

B) Play therapy

C) Family therapy

D) Behavior modification therapy

Q2) A child diagnosed with attention deficit hyperactivity disorder (ADHD) is going to begin medication therapy. The nurse should plan to teach the family about which classification of medications?

A) Central nervous system stimulants and non-stimulants

B) Monoamine oxidase inhibitors (MAOIs)

C) Antipsychotic medications

D) Anxiolytic medications

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Chapter 27: Adults

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Sample Questions

Q1) An adult has been feeling significant tension since losing a home through foreclosure. This person goes to a park, feeds the birds, and then impulsively exposes himself to a group of parents and children. Which term applies to this behavior?

A) Voyeurism

B) Frotteurism

C) Exhibitionism

D) Sexual masochism

Q2) The father of a child diagnosed with schizophrenia says, "I lost my job, so we have no health insurance." The mother says, "I must watch this child all the time. Without supervision, our child becomes violent and destructive." A sibling says, "My parents don't pay attention to me." These comments signify:

A) life-cycle stressors.

B) psychobiologic issues.

C) family burden of mental illness.

D) stigma associated with mental illness.

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Chapter 28: Older Adults

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Sample Questions

Q1) An 80-year-old patient has difficulty walking because of arthritis and says, "It's awful to be old. Every day is a struggle. No one cares about old people." Which is the nurse's most therapeutic response?

A) "Everyone here cares about old people. That's why we work here."

B) "It sounds like you're having a difficult time. Tell me about it."

C) "Let's not focus on the negative. Tell me something good."

D) "You are still able to get around, and your mind is alert."

Q2) Which beliefs facilitate provision of safe, effective care for older adult patients? (Select all that apply.)

A) Sexual interest declines with aging.

B) Older adults are able to learn new tasks.

C) Aging results in a decline in restorative sleep.

D) Older adults are prone to become crime victims.

E) Older adults are usually lonely and socially isolated.

Q3) An advance directive gives valid direction to health care providers when a patient is:

A) aggressive.

B) dehydrated.

C) unable to verbally communicate.

D) unable to make health care decisions.

To view all questions and flashcards with answers, click on the resource link above.

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